Healthcare Provider Details

I. General information

NPI: 1699449108
Provider Name (Legal Business Name): SOFIE ROSE PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 NW 54TH ST STE 321
SEATTLE WA
98107-3573
US

IV. Provider business mailing address

7150 45TH AVE SW
SEATTLE WA
98136-2002
US

V. Phone/Fax

Practice location:
  • Phone: 425-686-9570
  • Fax:
Mailing address:
  • Phone: 206-913-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70002599
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: